Abstract
People with intellectual disabilities (ID) are more often exposed to potentially traumatic events than people without ID. Due to impairments in their cognitive and adaptive skills, processing adverse life events is supposed to be more difficult. This chapter contains an overview of the literature on the (1) manifestations and assessment of posttraumatic stress disorder (PTSD) in people with ID and (2) treatment (i.e., trauma-focused cognitive behavioral therapy [TF-CBT] and eye movement desensitization and reprocessing [EMDR] therapy) of PTSD symptoms in people with ID. There is evidence to suggest that manifestations of PTSD in children with ID correspond with those in children without ID. To assess the effects of psychological trauma in children and to establish the diagnosis of PTSD, the Adapted ADIS-C PTSD Section appears to be a valid and reliable clinical interview. To determine the severity of PTSD symptoms in adults, two questionnaires with good psychometric properties are available (i.e., LANTS; IES-IDs). TF-CBT and EMDR therapy are the only psychotherapies recommended by the World Health Organization (WHO) for the treatment of PTSD. However, the literature on the treatment of manifestations of PTSD in people with ID is limited to case reports showing positive outcomes. For persons with ID suffering from PTSD, EMDR therapy seems most suited, particularly considering its nonverbal character and the lack of need to do homework and practice outside the sessions. Controlled studies are needed to establish empirical support for PTSD treatments in this population at risk for the development of PTSD.
Similar content being viewed by others
Abbreviations
- AAIDD:
-
American Association on Intellectual and Developmental Disability
- ADIS-C:
-
Anxiety disorder interview scale- children
- ASD:
-
Autism spectrum disorder
- CBT:
-
Cognitive behavioral therapy (CBT)
- DM-ID:
-
Diagnostic Manual-Intellectual Disability
- DSM:
-
Diagnostic and Statistical Manual of Mental Disorders
- EMDR:
-
Eye movement desensitization and reprocessing
- ID:
-
Intellectual disability (ID)
- IES:
-
Impact of Event Scale
- IES-IDs:
-
Impact of Event Scale-Intellectual Disabilities
- LANTS:
-
Lancaster and Northgate Trauma Scales
- MBID:
-
Mild to borderline intellectual disability
- PTSD:
-
Posttraumatic stress disorder
- SUDs:
-
Subjective Units of Disturbance scale
- VoC:
-
Validity of Cognition Scale
- WHO:
-
World Health Organization
References
Adler-Tapia R, Settle C. EMDR and the art of psychotherapy with children. New York: Springer; 2008.
Alisic E, Jongmans M, van Wesel F, Kleber R. Building child trauma theory from longitudinal studies: a meta-analysis. Clin Psychol Rev. 2011;31:736–47.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
Baddeley A. Human memory: theory and practice. Needham Heights: Allyn and Bacon; 1998.
Barol B, Seubert A. Stepping stones: EMDR treatment of individuals with intellectual and developmental disabilities and challenging behavior. J EMDR Pract Res. 2010;4:156–169.
Barrowcliff A, Evans G. EMDR treatment for PTSD and intellectual disability: a case study. Adv Ment Health Intellect Disabil. 2015;9(2):90–8.
Cooper S, Smiley E, Morrison J, Williamson A, Allan L. Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. Br J Psychiatry. 2007;190:27–35.
Dilly R. Eye movement desensitisation and reprocessing in the treatment of trauma with mild intellectual disabilities: a case study. Adv Ment Health Intellect Disabil. 2014;8(1):63–71.
Edwards V, Holden G, Felitti V, Anda R. Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study. Am J Psychiatry. 2003;160:1453–60.
Einfeld S, Ellis L, Emerson E. Co morbidity of intellectual disability and mental disorder in children and adolescents: a systematic review. J Intellect Dev Disabil. 2011;36:137–43.
Engelhart I, van den Hout M, Smeets M. Taxing working memory reduces vividness and emotionality of images about the Queen’s Day tragedy. J Behav Ther Exp Psychiatry. 2011;42:32–7.
Esbensen A, Benson B. A prospective analysis of life events, problem behaviors and depression in adults with intellectual disability. J Intellect Disabil Res. 2006;4:248–58.
Fernando K, Medlicott L. My shield will protect me against teh ANTS: Treatment of PTSD in a client with an intellectual disability. J Intellect Dev Disabil. 2009;34:187–192.
Fletcher R, Loschen E, Stavrakaki C, First M, editors. Diagnostic Manual-Intellectual Disability (DM-ID): a textbook of diagnosis of mental disorders in persons with intellectual disability. Kingston: NADD Press; 2007.
Focht-New G, Clements P, Barol B, Faulkner M, Pekala K. Persons with developmental disabilities exposed to interpersonal violence and crime: strategies and guidance for assessment. Perspect Psychiatr Care. 2008;44(1):3–13.
Gilderthorp C. Is EMDR an effective treatment for people diagnosed with both intellectual disability and post traumatic stress disorder? J Intell Dis. 2015;19:58–68.
Giltaij H. Alsof er een stofzuiger door mijn hoofd is gegaan. EMDR bij mensen met een visuele en verstandelijke beperking. [As if a vacuum cleaner went through my head. EMDR in people with visual and intellectual disabilities]. Tijdschrift voor Kinder- & Jeugdpsychotherapie [J Child Adol Psychother]. 2004; 3:81–97.
Hall J, Jobson L, Langdon P. Measuring symptoms of post-traumatic stress disorder in people with intellectual disabilities: the development and psychometric properties of the Impact of Event Scale-Intellectual Diabilities (IES-IDs). Br J Clin Psychol. 2014;53:315–32.
Hatton C, Emerson E. The relationship between life events and psychopathology amongst children with intellectual disabilities. J Appl Res Intellect Disabil. 2004;17:109–17.
Hollins S, Sinason V. Psychotherapy, learning disabilities and trauma: new perspectives. Br J Psychiatry. 2000;76:32–6.
Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41:209–18.
Jones R, Banks R. Behavioural treatment of PTSD in a person with intellectual disability. Eur J Behav Anal. 2007;8:251–6.
Lemmon V, Mizes J. Effectiveness of exposure therapy: a study of posttraumatic stress disorder and mental retardation. Cogn Behav Pract. 2002;4:317–23.
Levitas A, Gilson, S. Predictable crisis in the life of people with mental retardation. Ment Hlth Asp Dev Dis. 2001;3:89–100.
Lovett J. Small wonders. Healing childhood trauma with EMDR. New York: The Free Press; 1999.
Martorell A, Tsakanikos E. Traumatic experiences and life events in people with intellectual disability. Curr Opin Psychiatry. 2008;5:445–8.
Mevissen L, De Jongh A. PTSD and its treatment in people with intellectual disabilities. Clin Psychol Rev. 2010;30:308–16.
Mevissen L, Lievegoed R, De Jongh A. EMDR treatment in people with mild ID and PTSD: 4 cases. Psychiatry Q. 2011a;82:43–57.
Mevissen L, Lievegoed R, Seubert A, De Jongh A. Do persons with intellectual disability and limited verbal capacities respond to trauma treatment? J Intellect Dev Disabil. 2011b;36:278–83.
Mevissen L, Lievegoed R, Seubert A, De Jongh A. PTSD treatment in people with severe intellectual disabilities: a case series. Dev Neurorehabil. 2012;15:223–32.
Mevissen L, Barnhoorn E, Didden R, Korzilius H, De Jongh A. Clinical assessment of PTSD in children with mild to borderline intellectual disabilities: a pilot study. Dev Neurorehabil. 2014;17:16–23.
Mevissen L, Didden R, Korzilius H, De Jongh A. Assessment of posttraumatic stress disorder in children with mild to borderline intellectual disabilities. Manuscript submitted for publication.
Priebe S, Mtanov A, Gavrilović J, Crone P, Ljubotina D, Knežević G, Kučukalić A, Frančišković T, Schützwohl M. Consequences of untreated posttraumatic stress disorder following war in former Yugoslavia: morbidity, subjective quality of life and care costs. Croat Med J. 2009;50:465–75.
Rodenburg R, Benjamin A, De Roos C, Meijer A, Stams G. Efficacy of EMDR in children: A meta-analysis. Clin Psych Rev. 2009;29:599–606.
Schalock R, Borthwick-Duffy S, Bradley V, Buntinx W, Coulter D, Craig E, et al. Intellectual disability: definition, classification, and systems of supports. 11th ed. Washington, DC: AAIDD; 2010.
Shapiro F. Eye movement desensitization and reprocessing: basic principles, protocols and procedures. 2nd ed. New York: Guilford Press; 2001.
Shapiro F. EMDR and case conceptualization from an adaptive information processing perspective. In: Shapiro F, Kaslow L, Maxfield A, editors. Handbook of EMDR and family therapy processes. Hoboken/New York: Wiley; 2007. p. 3–34.
Stenfert Kroese B, Thomas G. Treating chronic nightmares of sexual assault survivors with an intellectual disability-two descriptive case studies. J Appl Res Intellect Disabil. 2006;19:75–80.
Sturmey P, Didden R, editors. Evidence-based practice and intellectual disabilities. Oxford: Wiley-Blackwell; 2014.
Taylor J, Lindsay W, Hastings R, Hatton C, editors. Psychological therapies for adults with intellectual disabilities. Oxford: Wiley-Blackwell; 2013.
Tomasulo D, Razza N. Posttraumatic stress disorder. In: Fletcher R, Loschen E, Stavrakaki C, First M, editors. Diagnostic Manual-Intellectual Disability (DM-ID): a textbook of diagnosis of mental disorders in persons with intellectual disability. Kingston: NADD Press; 2007. p. 365–78.
Weiss D, Marmar C. The impact of event scale–revised. In: Wilson J, Keane T, editors. Assessing psychological trauma and PTSD: a handbook for practitioners. New York: Guilford Press; 1997. p. 399–411.
Wigham S, Hatton C, Taylor J. The effects of traumatizing life events on people with intellectual disabilities: a systematic review. J Ment Health Res Intellect Disabil. 2011a;4:19–39.
Wigham S, Hatton C, Taylor J. The Lancaster and Northgate trauma scales (LANTS): the development and psychometric properties of a measure of trauma for people with mild to moderate intellectual disabilities. Res Dev Disabil. 2011b;32:2651–9.
Wigham S, Taylor J, Hatton C. A prospective study of the relationship between adverse life events and trauma in adults with mild to moderate intellectual disabilities. J Intellect Dev Disabil. 2014;58:1091–184.
World Health Organization. Guidelines for the management of conditions specifically related to stress. Geneva: World Health Organization; 2013.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this entry
Cite this entry
Mevissen, L., Didden, R., de Jongh, A. (2015). Assessment and Treatment of PTSD in People with Intellectual Disabilities. In: Martin, C., Preedy, V., Patel, V. (eds) Comprehensive Guide to Post-Traumatic Stress Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-08613-2_95-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-08613-2_95-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Online ISBN: 978-3-319-08613-2
eBook Packages: Springer Reference Behavioral Science and PsychologyReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences
Publish with us
Chapter history
-
Latest
Assessment and Treatment of PTSD in People with Intellectual Disabilities- Published:
- 10 February 2016
DOI: https://doi.org/10.1007/978-3-319-08613-2_95-2
-
Original
Assessment and Treatment of PTSD in People with Intellectual Disabilities- Published:
- 04 September 2015
DOI: https://doi.org/10.1007/978-3-319-08613-2_95-1